The invention relates generally to systems for, and methods of, automatically dispensing medication in a home setting in accordance with a predetermined schedule, and relates specifically to systems which are both easy to use by elderly or disabled people yet provide protection against underdosage as well as overdosage.
Underdosage protection relates to a device's ability to alert a patient of the proper time to take medication. Overdosage protection relates to the ability of a pill device to prevent a user from taking more than one medication dose in a relatively short period of time. For example, overdosage could occur if a patient misses taking a medication on time and takes the missed medication immediately prior to the next dosage period. Overdosage would occur if the patient is permitted access to and takes both the untaken dose as well as the next dose soon thereafter.
Non-compliance with self-administered medication schedules is a costly health care problem. Approximately one third (11 million) of the non-institutionalized elderly experience at least some minor confusion sufficient to interfere with their normal activities of daily living, such as the taking of medication on a prescribed schedule. As the health care industry changes within the next several years, the importance of avoiding complications by employing preventive procedures such as the use of intelligent pill dispensers for home use will likely increase. Present pill devices, however are not well suited for such demanding applications.
Present pill providing devices include (1) reference aids for referencing when to take medication, (2) controlled access devices for limiting pill access to predefined periods of time, and (3) controlled medication dispensing devices which eject medication at predetermined times. Devices of category (1) are passive reference aids which do not prevent access to medication.
Devices of category (2), such as those disclosed in U.S. Pat. Nos. 4,725,997; 4,695,954; 4,572,403; 4,310,103; 4,223,801; 3,762,601; and 3,722,739, generally require that a user reach into the device to retrieve the medication at certain periods of time. Unfortunately such devices are difficult for individuals having low manual dexterity skills to use due to the requirement that a patient reach into an exposed recess.
Devices of category (3), such as those disclosed in U.S. Pat. Nos. 4,953,745; 4,872,591; 4,763,810; 4,747,514; 4,674,652; and 3,964,638, generally dispense or eject medication automatically on a timed sequence. These devices, however, do not adequately provide protection against overdosage in the situation when medication is not timely taken. Because such devices eject medication automatically, overdosage may occur.
Additional devices of category (3) include those disclosed in U.S. Pat. Nos. 3,968,900 and 3,368,967. These devices generally dispense or eject medication following a request by a user in cooperation with a timer. Although the dispensing mechanisms turn off their respective timers such that a predetermined period of time must elapse between dispenses, all of the medication doses for such devices must be the same since it is not known when specific doses will be taken. This may lead to adverse drug reactions if, for example, certain medication which should not be taken with food is taken at meal time because earlier medications were not taken on time. Also, no record is kept of the scheduling deviations that may occur with such an altered timing schedule.
Additionally, present devices are not sufficiently flexible in their ability to respond to various conditions involving interruptions in the dispensing schedule. A medication dispenser should be able to respond to interruptions by readjusting the schedule if necessary, or by preventing certain medication from being made available if requested too late.
Interruptions in a schedule can occur if medication is taken early, taken late, or not taken at all for a certain dosage period. The determination of how to adjust one's medication schedule once an interruption has occurred, is a difficult decision for many people. Questions whether the schedule should be shifted forward in time, whether the patient should skip the last dose, whether the patient should take both doses, or whether the patient should skip the next dose, are not always easily answered. Such answers regarding the most appropriate course of action depend upon the medication involved as well as the amount of time of the deviation.
Other shortcomings of present dispensing or access devices include the inability of a patient to take a medication early if he or she will not be able to take the dose at the scheduled time. For example, if medication is to be taken once every 4 hours, and a patient is planning to leave their house fifteen minutes prior to the next dose period, then it may be proper for the patient to take the dose early. In fact, the patient may even wish to take the dose with them. However, it is generally not possible to do this with present devices while remaining on the appropriate timing schedule.
There is a need therefore, for a medication dispensing device that is easy to use by elderly and disabled individuals, and adequately prevents overdosage. Specifically, there is a need for a device that dispenses medication doses and collects untaken doses so as to make them unavailable to the patient.
There is a further need for a medication dispensing device which provides ample feedback to a patient's inquiry regarding the status of doses taken or not taken, as well as when the next dose will be made available.
There is also a need for a medication dispensing device which is capable of alerting individuals other than the patient of problems that arise in connection with the administration of medication.